Tesis

Insidens dan Faktor Risiko terjadinya Pneumonia pada Anak Palsi Serebral Spastik = Incidence and Risk Factor of Pneumonia in Children with Spastic Cerebral Palsy.

Latar belakang. Pneumonia merupakan salah satu penyebab mortalitas pada anak palsi serebral (PS) karena manifestasi klinisnya yang berat serta risiko kejadian gagal napas yang lebih besar dibandingkan anak normal. Insidens pneumonia pada anak PS bervariasi dapat mencapai 20%. Anak dengan PS memiliki berbagai disfungsi yang erat kaitannya dengan masalah respiratori namun masih sedikit studi yang membuktikan hubungannya terhadap kejadian pneumonia. Tujuan. Mengetahui insidens pneumonia pada anak PS spastis, pengaruh derajat berat PS (dinilai dengan GMFCS), tetraparesis, epilepsi, obstructive sleep apneu (OSA), gangguan bersihan jalan napas, PRGE, dan disfagia terhadap kejadian pneumonia Metode. Penelitian ini adalah penelitian observasional dengan desain potong lintang yang dilakukan di RSCM. Hasil. Terdapat 82 subyek yang diikutsertakan dalam penelitian ini. Insidens pneumonia didapatkan 37,8%. Faktor risiko yang paling berhubungan terhadap pneumonia adalah gangguan bersihan jalan napas (p=0,011, adjusted OR 10,995 , IK 95% 3,087-39,160) dan disfagia napas (p= < 0,001, adjusted OR 8,641, IK 95% 1,65045,244) memiliki peran utama dalam terjadinya pneumonia Kesimpulan. Gangguan bersihan jalan napas dan disfagia memiliki peran penting dalam kejadian pneumonia pada anak PS.
Kata kunci: Palsi serebral, pneumonia, faktor risiko.


Background. Pneumonia is one of the causes of mortality in children with cerebral palsy (CP) due to more severe clinical manifestations and a greater risk of respiratory failure than normal children. The prevalence of pneumonia in CP children varies up to 20%. Children with PS have various dysfunctions that are closely related to respiratory problems, but there are still few studies that prove the relationship to the incidence of pneumonia. Objectives. To evaluate the incidence of pneumonia in spastic PS children, the effect of PS severity (assessed by GMFCS), tetraparesis, epilepsy, obstructive sleep apneu (OSA), airway clearance disorders, GERD, and dysphagia on the incidence of pneumonia. Method. This study is an observational study with a cross-sectional design conducted at the RSCM. Result. There were 82 subjects who were included in this study, as many as 37,8% of subjects had a history of pneumonia. The most associated risk factors for pneumonia were impaired airway clearance (p = 0.011, adjusted OR 10.995, 95% CI 3.087-39.160) and respiratory dysphagia (p = < 0.001, adjusted OR 8,641, 95% CI 1.650-45,244). major in the occurrence of pneumonia Conclusion. Impaired airway clearance and dysphagia have a major role in the development of pneumonia.
Kata kunci: Palsi serebral, pneumonia, faktor risiko.